See also Bacterial gastroenteritis and Diarrhea

Gastroenteritis is a general term referring to inflammation or infection of the gastrointestinal tract, primarily the stomach and intestines.^[1] It can be caused by infection with bacteria, viruses, or other parasites, or less commonly reactions to new foods or medications. It often involves stomach pain or spasms (sometimes to the point of being crippling), diarrhea and/or vomiting, with noninflammatory infection of the upper small bowel, or inflammatory infections of the colon.^[2][3][4][5] The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // A00-A79 - Bacterial infections, and other intestinal infectious diseases, and STDs (A00-A09) Intestinal infectious diseases (A00) Cholera (A01) Typhoid and paratyphoid fevers (A010) Typhoid fever (A02) Other Salmonella infections (A03) Shigellosis (A04) Other bacterial intestinal infections (A040) Enteropathogenic Escherichia coli infection (A045) Campylobacter enteritis (A046) Enteritis due to Yersinia... // J00-J99 - Diseases of the respiratory system (J00-J06) Acute upper respiratory infections (J00) Acute nasopharyngitis (common cold) (J01) Acute sinusitis (J02) Acute pharyngitis (J03) Acute tonsillitis (J04) Acute laryngitis and tracheitis (J05) Acute obstructive laryngitis (croup) and epiglottitis (J050) Acute obstructive laryngitis (croup) (J051) Acute epiglottitis (J06) Acute upper... // K00-K93 - Diseases of the digestive system (K00-K14) Diseases of oral cavity, salivary glands and jaws (K00) Disorders of tooth development and eruption (K01) Embedded and impacted teeth (K02) Dental caries (K03) Other diseases of hard tissues of teeth (K04) Diseases of pulp and periapical tissues (K040) Pulpitis (K05... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Bacterial gastroenteritis is an inflammation of the stomach and intestines caused by bacteria or bacterial toxins. ... Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... An infection is the detrimental colonization of a host organism by a foreign species. ... Gut redirects here. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... In anatomy, the intestine is the segment of the alimentary canal extending from the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine. ... Phyla Actinobacteria Aquificae Chlamydiae Bacteroidetes/Chlorobi Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Lentisphaerae Nitrospirae Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Verrucomicrobia Bacteria (singular: bacterium) are unicellular microorganisms. ... This article is about biological infectious particles. ... An adverse drug reaction (abbreviated ADR) is a term to describe the unwanted, negative consequences sometimes associated with the use of medications. ... Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths... Emesis redirects here. ... Diagram showing the small intestine In biology the small intestine is the part of the gastrointestinal tract between the stomach and the large intestine (colon). ... It has been suggested that this article or section be merged with Large intestine. ...

It usually is of acute onset, normally lasting fewer than 10 days and self-limiting. Sometimes it is referred to simply as 'gastro'. It is often called the stomach flu or gastric flu even though it is not related to influenza.^[6] Instead, rotavirus is thought to cause half the incidence of gastroenteritis. In medicine, an acute disease is a disease with either or both of: a rapid onset; a short course (as opposed to a chronic course). ... In biology, a self-limiting organism or colony of organisms limits its own growth by its actions. ... Influenza, commonly known as flu, is an infectious disease of birds and mammals caused by RNA viruses of the family Orthomyxoviridae (the influenza viruses). ... This article or section does not adequately cite its references or sources. ...

If inflammation is limited to the stomach, the term gastritis is used, and if the small bowel alone is affected it is enteritis. In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... Gastritis is inflammation of the gastric mucosa. ... Enteritis is the inflammation of the small intestine (inflammation of the large intestine is termed colitis). ...

Epidemiology

Globally, gastroenteritis caused 4.6 million deaths in children in 1980 alone, most of these in the developing world.^[3] Harrison's Principles of Internal Medicine estimates the current total figure to be 2.4 to 2.9 million per year.^[4] This number has now come down significantly to approximately 1.5 million deaths annually, largely due to global introduction of proper oral rehydration therapy.^[7] For the Jamaican reggae band, see Third World (band). ... Harrisons Principles of Internal Medicine is an American textbook of internal medicine. ... Oral Rehydration Therapy, or ORT, is a simple, cheap, and effective treatment for diarrhea caused by, e. ...

The incidence in the developed countries is as high as 1-2.5 cases per child per year and a major cause of hospitalisation in this age group. A developed country is a country that is technologically advanced and that enjoys a relatively high standard of living. ...

Age, living conditions, hygiene and cultural habits are important factors. Aetiological agents vary depending on the climate. Furthermore, most cases of gastroenteritis are seen during the winter in temperate climates and during summer in the tropics.^[3] This article is about the medical term. ...

Also some symptoms of gastroenteritis can lead to pneumonia.

Clinical features

The main contributing factors include poor feeding in infants. Diarrhea is common, and may be (but not always) followed by vomiting. Viral diarrhea usually causes frequent watery stools, whereas blood stained diarrhea may be indicative of bacterial colitis. In some cases, even when the stomach is empty, bile can be vomited up. Colitis is a digestive disease characterized by inflammation of the colon. ... Bile (or gall) is a bitter, yellow or green alkaline fluid secreted by hepatocytes from the liver of most vertebrates. ...

A child with gastroenteritis may be lethargic, suffer lack of sleep, or run a low fever and have signs of dehydration, which include dry mucous membranes, tachycardia, reduced skin turgor, skin color discoloration, sunken fontanelles and sunken eyeballs and darkened eye circles, poor perfusion and ultimately shock. This article is being considered for deletion in accordance with Wikipedias deletion policy. ... Dehydration (hypohydration) is the removal of water (hydro in ancient Greek) from an object. ... This article or section does not cite any references or sources. ... Turgor (also called turgor pressure or osmotic pressure) is the pressure that can build in a space that is enclosed by a membrane that is permeable to a solvent of a solution such as water but not to the solutes of the soluton. ... In human anatomy, a fontanelle (or fontanel) is one of two soft spots on a newborn humans skull. ... In physiology, perfusion is the process of nutritive delivery of arterial blood to a capillary bed in the biological tissue. ... This article is about the medical condition. ...

Differential diagnosis

It is important to consider infectious gastroenteritis as a diagnosis per exclusionem. A few loose stools and vomiting may be the result of systemic infection such as pneumonia, septicemia, urinary tract infection and even meningitis. Surgical conditions like appendicitis, intussusception and, rarely, even Hirschsprung's disease may mislead the clinician. The term diagnosis of exclusion (per exclusionem) refers to a medical condition whose presence cannot be established with complete confidence from examination or testing. ... An infection is the detrimental colonization of a host organism by a foreign species. ... This article is about human pneumonia. ... Sepsis (in Greek Σήψις) is a serious medical condition caused by a severe systemic infection leading to a systemic inflammatory response. ... A urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary tract. ... Meningitis is the inflammation of the protective membranes covering the central nervous system, known collectively as the meninges. ... Appendicitis (or epityphlitis) is a condition characterized by inflammation of the appendix[1]. While mild cases may resolve without treatment, most require removal of the inflamed appendix, either by laparotomy or laparoscopy. ... An intussusception is a situation in which a part of the intestine has prolapsed into another section of intestine, similar to the way in which the parts of a collapsible telescope slide into one another. ... Hirschsprungs disease, or congenital aganglionic megacolon, involves an enlargement of the colon, caused by bowel obstruction resulting from an aganglionic section of bowel (the normal enteric nerves are absent) that starts at the anus and progresses upwards. ...

Non-infectious causes to consider are poisoning with heavy metals (i.e. arsenic, cadmium), seafood (i.e. ciguatera, scombroid, toxic encephalopathic shellfish poisoning) or mushrooms (i.e. Amanita phalloides). Secretory tumours (i.e. carcinoid, medullary tumour of the thyroid, vasoactive intestinal peptide-secreting adenomas) and endocrine disorders (i.e. thyrotoxicosis and Addison's disease) are disorders that can cause diarrhea. Also, pancreatic insufficiency, short bowel syndrome, Whipple's disease, coeliac disease, and laxative abuse should be excluded as possibilities.^[5] General Name, Symbol, Number arsenic, As, 33 Chemical series metalloids Group, Period, Block 15, 4, p Appearance metallic gray Standard atomic weight 74. ... General Name, Symbol, Number cadmium, Cd, 48 Chemical series transition metals Group, Period, Block 12, 5, d Appearance silvery gray metallic Standard atomic weight 112. ... Chemical structure of the ciguatoxin CTX1B Ciguatera is a foodborne illness poisoning in humans caused by eating marine species whose flesh is contaminated with a toxin known as ciguatoxin, which is present in many micro-organisms (particularly, the micro-algae Gambierdiscus toxicus) living in tropical waters. ... Scombroid is a foodborne illness poisoning associated with eating seafood that has been stored improperly. ... Binomial name (Vaill. ... Picture of a carcinoid tumour that encroaches into lumen of the small bowel. ... A VIPoma is an endocrine tumor, usually originating in the pancreas, which produces a vasoactive intestinal peptide and is believed to cause profound cardiovascular and electrolyte changes with vasodilatory hypotension, watery diarrhea, hypokalemia, and dehydration. ... Hyperthyroidism (thyrotoxicosis or fast thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) and free triiodothyronine (T3), or both. ... Addisons disease(also known as chronic adrenal insufficiency, hypocortisolism or hypocorticism) is a rare endocrine disorder in which the adrenal gland produces insufficient amounts of steroid hormones (glucocorticoids and often mineralocorticoids). ... Short bowel syndrome is a malabsorption disorder caused by either the surgical removal of the small intestine or the loss of its absorptive function due to diseases. ... Whipples disease is a rare disease caused by the bacteria Thropheryma whipplei. ... Coeliac disease or celiac disease is an autoimmune disorder of the small bowel that occurs in genetically predisposed individuals in all age groups after early infancy. ...

Before the 20th century, the word "gastroenteritis" was not commonly used. What would now be diagnosed as gastroenteritis may have instead been diagnosed as typhoid fever, cholera morbus, "griping of the guts", "surfeit", "flux", "colic", "bowel complaint", or any one of a number of other archaic names.^[8] Historians, genealogists, and other researchers should keep in mind that gastroenteritis was not considered a discrete diagnosis until fairly recently. For a similar disease with a similar name, see typhus. ... Cholera (or Asiatic cholera or epidemic cholera) is a severe diarrheal disease caused by the bacterium Vibrio cholerae. ...

Treatment

Rehydration

The principal treatment of diarrhea illness in both children and adults is rehydration, i.e. replenishment of water lost in the stools. Depending on the degree of dehydration, this can be done orally with oral rehydration solutions (ORS), commercial such as through ceralyte,^[9][10]) or home-made rehydration fluids, or through intravenous delivery. Symptoms may exhibit themselves for up to 6 days. Bowel movements will return to normal within a week after that. Rehydration is the pissing of water and electrolytes lost through dehydration. ... Oral Rehydration Therapy, or ORT, is a simple, cheap, and effective treatment for diarrhea caused by, e. ... In the circulatory system, a vein is a blood vessel that carries blood toward the heart. ...

Because of the stomach's fragility due to the illness, rehydration through the drinking of fluids must be slow and spaced out as to not overwhelm the stomach and cause further nausea and vomiting. Doctors recommend that one take slow sips every few minutes, and if vomiting still occurs, it is best to refrain from any drinking or eating for the next half hour. Although, some doctors recommend taking "gravol" and continue taking slow sips. Water is the best choice, acidic juices like orange juice and dairy products may cause further nausea.

Drug therapy

Antibiotics

When the symptoms are severe one usually starts empirical antimicrobial therapy, i.e. a fluoroquinolone antibiotic.^[2] Pseudomembranous colitis is treated by discontinuing the causative agent and starting with metronidazole or vancomycin.^[2][3][4][5] Quinolones and fluoroquinolones form a group of broad-spectrum antibiotics. ... Pseudomembranous colitis is an infection of the colon often, but not always, caused by the bacterium Clostridium difficile. ... Metronidazole (INN) (IPA: ) is a nitroimidazole anti-infective drug used mainly in the treatment of infections caused by susceptible organisms, particularly anaerobic bacteria and protozoa. ... Crystal structure of a short peptide L-Lys-D-Ala-D-Ala (bacterial cell wall precursor, in green) bound to vancomycin (blue) through hydrogen bonds. ...

Antidiarrheal agents

Loperamide is an opioid analogue commonly used for symptomatic treatment of diarrhea. It slows down gut motility, but does not cross the mature blood-brain barrier^[2] to cause the central nervous effect of other opioids. In too high doses, loperamide may cause constipation and significant slowing down of passage of feces, but an appropriate single dose will not slow down the duration of the disease.^[11] Although antimotility agents have the risk of exacerbating the condition, this fear is not supported by clinical experience according to Sleisenger & Fordtran's Gastrointestinal and Liver Disease and the Oxford Textbook of Medicine.^[2][5] Nevertheless, Harrison's Principles of Internal Medicine discourages the use of antiperistaltic agents and opiates in febrile dysentery, since they may mask, or exacerbate the symptoms.^[4] All these textbooks agree that in severe colitis antimotility drugs should not be used. Loperamide, usually as hydrochloride, is a drug effective against diarrhea resulting from gastroenteritis or inflammatory bowel disease. ... An opioid is a chemical substance that has a morphine-like action in the body. ... Peristalsis is the rhythmic contraction of smooth muscles to propel contents through the digestive tract. ... The blood-brain barrier (BBB) is a membranic structure that acts primarily to protect the brain from chemicals in the blood, while still allowing essential metabolic function. ... Harrisons Principles of Internal Medicine is an American textbook of internal medicine. ... Dysentery (formerly known as flux or the bloody flux) is frequent, small-volume, severe diarrhea that shows blood in the feces along with intestinal cramping and tenesmus (painful straining to pass stool). ... Three textbooks. ...

Loperamide prevents the body from flushing toxins from the gut, and should not be used when an active fever is present or there is a suspicion that the diarrhea is associated with organisms that can penetrate the intestinal walls, such as E. coli O157:H7 or salmonella. Escherichia coli O157:H7 is an emerging cause of foodborne illness. ... Species S. enterica This article is about the bacteria. ...

Loperamide is also not recommended in children, especially in children younger than 2 years of age, as it may cause systemic toxicity due to an immature blood brain barrier, and oral rehydration therapy remains the main stay treatment for children.

Bismuth subsalicylate (BSS), an insoluble complex of trivalent bismuth and salicylate, is another drug that can be used in mild-moderate cases.^[2][5] ...

Combining an antimicrobial drug and an antimotility drug, seems to be effective more rapidly.^[2][5]

Complications

Dehydration is the most serious complication of the diarrhea caused by gastroenteritis and needs prompt rectification by a clinician if severe. Dehydration (hypohydration) is the removal of water (hydro in ancient Greek) from an object. ... Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths...

Febrile convulsions are not uncommon in children, especially with rotavirus infections. A febrile seizure, also known as a fever fit or febrile convulsion is a generalized convulsion caused by elevated body temperature. ... This article or section does not adequately cite its references or sources. ...

Sugar malabsorption is the most common complication, especially in infants. This may result in the reappearance of diarrhea after milk, and hence the sugar lactose, is reintroduced into the diet. Malabsorption is the state of impaired absorption of nutrients in the small intestine. ... Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths... A glass of cows milk. ... Lactose is a disaccharide that consists of β-D-galactose and β-D-glucose molecules bonded through a β1-4 glycosidic linkage. ...

See also

• 1984 Rajneeshee bioterror attack
• Anal fissure
• Appendicitis
• Coeliac disease
• Constipation
• Crohn's disease

The 1984 Rajneeshee bioterror attack refers to the salmonella food poisoning of over seven hundred and fifty individuals in Oregon through the contamination of salad bars at ten local restaurants. ... An anal fissure is an unnatural crack or tear in the anus skin. ... Appendicitis (or epityphlitis) is a condition characterized by inflammation of the appendix[1]. While mild cases may resolve without treatment, most require removal of the inflamed appendix, either by laparotomy or laparoscopy. ... Coeliac disease or celiac disease is an autoimmune disorder of the small bowel that occurs in genetically predisposed individuals in all age groups after early infancy. ... Constipation or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to egest; it may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. ... Crohns disease (also known as regional enteritis) is a chronic, episodic, inflammatory condition of the gastrointestinal tract characterized by transmural inflammation (affecting the entire wall of the involved bowel) and skip lesions (areas of inflammation with areas of normal lining between). ...

References

The McGraw-Hill Companies, Inc. ... Oxford University Press (OUP) is a highly-respected publishing house and a department of the University of Oxford in England. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 102nd day of the year (103rd in leap years) in the Gregorian calendar. ...

Bibliography

• Victora, C. G., Bryce, J., Fontaine, O., & Monasch, R. 2000, 'Reducing deaths from diarrhoea through oral rehydration therapy', Bulletin of The World Health Organization, vol. 78, no. 10, pp. 1246-1255.
• Wingate D. et al. 2001. 'Guidelines for adults on self-medication for the treatment of acute diarrhea', Alimentary Pharmacology & Therapeutics, vol. 15, no. 6, pp. 773-782.

External links

• NHS Direct: Gastroenteritis. Retrieved on 2007-04-12.
• eMedicine Health:Gastroenteritis. Retrieved on 2007-04-12.
• The World Health Organisation: Diarrhoea. Retrieved on 2007-04-12.